Saturday, February 25, 2017

GOP Obamacare replacement "in situ" involves continuous coverage, risk pools, ending mandate, ending employer tax break

Vox has a detailed article on the “leaked” GOP plan to “replace” aka “repair” Obamacare, by Sarah Kiff, here.

There seem to be two key concepts in dealing with pre-existing conditions.  One of these ideas is allowing people with continuous coverage to keep plans at the standard rate.  That may help some.

 That means if you were covered before, then get cancer, and keep the same coverage even if you change jobs (the GOP wants you to), you don’t get charged higher premiums.

The other is helping states set up high-risk pools.

My personal belief that it is better to re-insure  claims from  certain conditions (or cover them the way we cover end-stage renal disease) rather than separate people and cover them differently. On the other hand, as a philosophical matter, it makes sense in the long run to privatize retirement (social security) and old age medical care (Medicare) because we will all get old and, from some starting point, should plan for it.

On the other hand, it seems wrong to require people to pay for other people’s known problems products they purchase from a market.  It sounds better to segregate the costs of these problems and fund their reimbursement publicly as necessary.

The GOP wants to end the tax break for employer plans, which tend to cherry pick healthier people.
States could allow plans to eliminate mandatory coverages – like maternity coverage for single men.
 The bill would also eliminate the individual mandate, which insurers maintain is necessary to counter anti-selection.

It also wants to reverse the expansion of Medicaid and change the whole thing into block grants to states (separate explainer).

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